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08-0847 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: -0-8=00Q00^ 84-7- - Property Address: 53664 VIA STRADA APN: 772-540-046- - - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5990 Tiht 4 stP Qulk& Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I3 affirm under penalty of perjury t m licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bu ' ess d.Professionals Code, and my License is in full force and effect. License Class: B License No.: 870215 C ra or. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish; or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( ) I am exempt under Sec. _ , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is aconstruction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: ' Lender's Address: — P[Pf LQPERMIT Owner: KESSLER 53664 VIA STRADA LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 5/15/08 Contractor: SHK DEVELOPMENT INC 73700 DINAH SHORE #204' PALM DESERT, CA 92211- (760)770-8040 2211(760)770-8040 Lic. No.: 870215 J WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is .issued. - _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier EXEMPT Policy Number EXEMPT I certify that, in the Performa .f the work for which this permit is issued; I shall not employ any , person in any manner s s to ecome subject to the workers' compensation laws of California, _and agree that, if I s Id be me subject to the workers' compensation provisions of Section 3700 of the Labor ode, I all forthwith comply with those provisions. WARNING: FAILURE TO SfUWM WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND -ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT. Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced . within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and stateertyfor mation is correct. I agree to comply with all city and county ordinances and state laws relatinction, and hereby authorize representatives of thi'I :unty to� r upo the above-mentionedion purposes. f_�//nature (Applicant or Ag Application Number 08-00000847 Permit ., . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . 81.00 Plan Check Fee 00 Issue Date Valuation 5990 Expiration.Date 11/11/08 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 THOU BLDG 2,001-25,000 36.00 - --------------------------------------- Special Notes and Comments 230 L.F. 6' GARDEN WALLS AT VARIOUS LOCATIONS AT PROPERTY, 'CITY STANDARD Fee summary Charged Paid Credited Due -------- ---------- ---------- Permit Fee Total 81.00 .00 ----------. 00 .81.00 Plan Check Total .00 00 .00 .00 Grand Total 81.00 .00 00. 81.00 c ' LQPERMIT - .